ESTROGEN and PROGESTERONE RECEPTORS IN GALLBLADDER DISEASE: On the cusp of a discovery? (#1205)

Background:Carcinoma Gallbladder
is one of the most common malignancies of the gastrointestinal tract having a
very poor prognosis with a high incidence in North India. Untreated chronic
symptomatic cholelithiasis is one of the main risk factors with a female predilection.
Impaired gallbladder emptying during menses & pregnancy & higher
incidence of gallbladder diseases in females with high parity & prolonged
fertility have all indicated the gallbladder to be female sex hormone
responsive. This has been supported by some studies & refuted by others.
Therefore a consensus is largely lacking, forming which, can further help in
studying the therapeutic implications of hormone modulators in gallbladder
pathology and its progression to malignancy

Methods: Hospital-based
descriptive type of observational study including all cases of gallbladder
disease undergoing surgical management in the Sawai Man Singh Medical College,
Jaipur, India during the study period. Resected specimen were evaluated for
presence of the receptors by Immunohistochemistry and clinical significance was
evaluated.

Results: 92 cases of gallbladder disease were included. Age interval of the cases was from
18yrs (youngest) to 80yrs (oldest) with most of the cases clustered in the 4th
decade of life. 72 cases had gallstone disease. 11 cases were malignant. Statistical significance for Estrogen receptor was not achieved but Progesterone receptor expression was statistically significant.

Conclusions:We conclude that significant progesterone receptor expression was noted and confirm that gallbladder is a female sex hormone responsive organ. A multicentric trial involving larger number of cases of gallbladder malignancies would go a long way in potentiating therapeutic applications of hormone modulators in their prevention, treatment or palliation.